A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in San Diego County. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Signature (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Aetna Medicare Signature (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2000.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Aetna Medicare Signature (HMO) features an Enhanced Alternative drug benefit with a $615 annual prescription drug deductible. Once you meet this deductible, you pay no copay for Tier 1 preferred generic drugs at preferred pharmacies or through preferred mail order, while standard options require a $12 copay. For Tier 2 standard generics, you will pay a 24% coinsurance regardless of the pharmacy or mail service you choose. Tier 3 preferred brands and Tier 4 non-preferred drugs both require a 25% coinsurance during the initial coverage phase. After your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescriptions. Additionally, individuals who qualify for the low-income subsidy will pay nothing for their Part D coverage.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers robust coverage for essential medical services, often with no copay or coinsurance for routine care. Members enjoy no copay for primary care, specialist, and mental health visits, as well as for urgent care and routine preventive services. For more intensive care, inpatient hospital stays require a $300 daily copay for the first five days, while emergency room visits carry a $150 copay that is waived upon admission. This plan also includes valuable supplemental benefits, featuring no copay or coinsurance for routine vision and hearing exams, preventive dental care, and home health services. Prescription hearing aids and annual eyewear are covered with no copay up to specified annual limits, while comprehensive dental services require a 20% to 50% coinsurance. Diagnostic tests, lab services, and outpatient X-rays are also fully covered with no copay or coinsurance, making everyday healthcare highly affordable.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by Aetna Medicare Signature (HMO) with no coinsurance, requiring a $300 daily copay for days 1 to 5 and no copay for days 6 to 90 for both acute and psychiatric stays. Prior authorization is required, and while unlimited additional acute stays are covered, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO) covers outpatient services with no coinsurance, featuring a $0 to $200 copay for outpatient hospital services and a $300 copay per stay for observation services. Ambulatory surgical center visits, outpatient substance abuse sessions, and outpatient blood services are covered with no copays.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization benefits with no coinsurance, although prior authorization is required. Depending on the service, members will pay either no copay or a $180 copay.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature (HMO), with prior authorization required for ambulance services. Ground ambulance services require a $245 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Plan-approved transportation is covered with no copay and no coinsurance for up to 6 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay and no coinsurance, while worldwide emergency and urgent care are available up to a $250,000 limit with copays ranging from $150 to $245 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO) partially covers primary care benefits, with podiatry services excluded from coverage. Most covered services, including primary care physician, specialist, and mental health visits, feature no copay and no coinsurance, while additional telehealth benefits require a 20% coinsurance and no copay.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO), featuring no copay and no coinsurance for annual exams, fitness benefits, and health education, while kidney disease education requires a 20% coinsurance and no copay. Uncovered sub-services include in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO), offering routine exams, fitting evaluations, and prescription hearing aids with no copay and no coinsurance. While covered prescription hearing aids have a $1,250 annual maximum benefit per ear, OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, including one annual routine eye exam and diabetic eye exams. Eyewear, including contact lenses, eyeglasses, and upgrades, is also covered with no copay or coinsurance up to a combined maximum benefit of $100 every year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), offering no copay and no coinsurance for preventive care such as exams, cleanings, and x-rays. Comprehensive services require a 20% to 50% coinsurance and no copay up to a $1,000 annual limit, while fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with prior authorization required. Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Aetna Medicare Signature (HMO) covers dialysis services with a 20% coinsurance and no copay, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. Beneficiaries will pay no copay and no coinsurance for medical supplies and diabetic shoes, while DME, prosthetics, and diabetic supplies have no copay and coinsurance ranging from 0% to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance for diagnostic tests, lab services, diagnostic radiology, and outpatient X-rays. Therapeutic radiological services require a 20% coinsurance, and prior authorization or doctor referrals are required for these services.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (HMO) plan with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (HMO) plan, as all individual sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) services, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Aetna Medicare Signature (HMO) with prior authorization, though additional days beyond the Medicare-covered limit are not covered. You will pay a $20 daily copay with no coinsurance for days 1 to 20, and a $218 daily copay with no coinsurance for days 21 to 100.
Other Services See details
Aetna Medicare Signature (HMO) partially covers Other Services, providing acupuncture, annual wellness exams, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Over-the-counter (OTC) items, meal benefits, and dual eligible SNPs with highly integrated services are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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